<%@ include file="header.jsp" %>
  <!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
           
  
    
    <div class="right_content">            
           

<h2>veuillez saisir les données </h2>
  <form id="form1" action="/" method="post">	
		
			<fieldset><legend>Contact form</legend>
				<p class="first">
					<label for="name">Nom</label>
					<p></p>
					<input type="text" name="name" id="name" size="30" />
				</p>
	<p>
					<label for="message">Prénom </label>
					<p></p>
					<input type="text" name="name" id="name" size="30" />
				</p>	
				<p>
					<label for="message">fonction</label>
					<p></p>
					<input type="text" name="name" id="name" size="30" />
				</p>
				<p>
					<label for="message">telephone </label>
					<p></p>
					<input type="text" name="name" id="name" size="30" />
				</p>
				<p>
					<label for="message">Email</label>
					<p></p>
					<input type="text" name="name" id="name" size="30" />
				</p>
				<p>
					<label for="message">Role</label>
					<p></p>
					<input type="text" name="name" id="name" size="30" />
				</p>
				<p>
					<label for="message">province </label>
					<p></p>
					<input type="text" name="name" id="name" size="30" />
				</p>
				</fieldset>
						

			<p class="submit"><button type="rechercher">Valider</button></p>		
						
		</form>
     
   
     
     </div><!-- end of right content-->
            
                    
  </div>   <!--end of center content -->               
                    
                    
    
    
    <div class="clear"></div>
    </div> <!--end of main content-->
	
   

</div>		
</body>
</html>